Molar Hcg

Clinical Use:

To detect and follow-up a hydatidiform or molar pregnancy.

Background:

A molar pregnancy is an abnormal pregnancy in which an embryo either develops incompletely, or doesn’t develop at all. Instead, a cluster of grape-like cysts (known as a hydatidiform mole) grows in the uterus. In a partial molar pregnancy, an incomplete embryo and placenta may actually start to develop.Molar pregnancies occur approximately once every 1,000 pregnancies. They are more common in women who are older than 40 years and in women who have had two or more miscarriages. Partial molar pregnancies occur less frequently.

The most prominent symptom of a molar pregnancy is heavy bleeding from the vagina early in the pregnancy. The blood may be dark brown. Symptoms of a partial molar pregnancy include severe nausea, vomiting, and hypertension, early in the pregnancy, often in the first trimester.

The physician diagnoses a molar pregnancy by performing an ultrasound, which will reveal the presence of cysts in the uterus. The physician will also perform another test that measures the levels of beta human chorionic gonadotropin (HCG). Beta HCG is a hormone that pregnant women produce. It appears in the blood or urine a week after the egg has been fertilized. Beta HCG levels are higher than normal in a molar pregnancy.

A partial molar pregnancy is treated by removing the embryo and placenta from the uterus. This is done with a surgical procedure known as a suction curettage, in which the cervix is dilated (opened) and the embryo and placenta are removed from the uterus.

In a small number of partial molar pregnancy cases, there will be some molar tissue remaining in the uterus after the suction curettage. This tissue is known as gestational trophoblastic disease and may continue to grow. It can be treated with Methotrexate, a medication that is also used to treat cancer. In rare cases, the gestational trophoblastic disease may develop into a cancer (known as a choriocarcinoma). This, too, can be treated with anti-cancer agents. Following evacuation of a molar pregnancy follow-up treatment includes measuring serial serum HCG until levels are normal – a rising HCG could indicate choriocarcinoma.